Selecting a Focal Point

One of the most important decisions that you make prior to cataract surgery is what focal point you would like for your vision postoperatively. Understanding your options – and the benefits and limitations of each choice – are critical to feeling satisfied with your outcome.

The intraocular lens (IOL) that is implanted into your eye during cataract surgery determines the focal point of the eye after surgery. IOLs come in a range of focusing powers, just like glasses. Depending on the power of the IOL that is implanted into your eye, your clearest vision could be in the distance, at medium range, or close up.

The standard monofocal IOL has only a single focal point. This means that you will have good uncorrected vision at one distance (far away, mid-range, or close), but you will need glasses for all other distances. Most people choose to have an IOL that provides clear distance vision without glasses, which means that they must use reading glasses for near work. Other people choose an IOL that allows them to read without glasses, and then they wear glasses for far-away activities like driving and watching TV.

It is important to recognize that with a monofocal IOL, you will have good uncorrected vision at one particular distance, but you will need to wear glasses for activities done at any other distance.

The standard monofocal IOL does not correct astigmatism. Therefore, if you have astigmatism, your vision will not be clear at any distance – even at the focal point of the IOL. Clear vision will require wearing glasses for all distances (far away, mid-range, and near), because the glasses will be needed to correct the astigmatism. Thankfully, a different type of IOL is available that corrects astigmatism: the Toric IOL. This lens implant offers patients with astigmatism the same options that a monofocal IOL offers to patients without astigmatism; that is, good uncorrected vision at one particular focal point, and glasses only for activities done at other distances.

If you are motivated to reduce your dependence on glasses at all distances (near, intermediate, and far), several options are available. One option is to do monovision. In this situation, a monofocal IOL is implanted into each eye; however, one eye is set for distance and the other eye is set for near. A second option is to choose a multifocal IOL. These IOLs have multiple focal points within the lens implant and therefore give you clear vision at multiple distances. Multifocal IOLs come in many styles, and each has its benefits and drawbacks.

No lens implant or focal point is better than any other – the choice is a personal preference. Still, depending on your other eye problems or your other health problems, some options might not be right for you. The surgeons at New England Vision will discuss these details with you and answer your questions so that you end up with the very best lens for your individual eye.